9. Seasickness and Health at Sea

by Paul Motter | Tuesday, 05 Mar. 2013

This will be a short section because the claims of "cruise ship viruses" are vastly over-stated. Here is why this happens. Norovirus, which has been dubbed the "cruise ship disease," is not the cruise ship disease at all. This particular virus is everywhere and is second to only the common cold in terms of prevalence in the American public.

Unfortunately, a very good intention by the cruise industry turned into a public relations nightmare. Norovirus is not a "reportable disease" according to the Nation Center for Disease Control (CDC). An example of a reportable disease is Legionnaires Disease, where an outbreak can be fatal. However, in a gesture of good will the cruise industry volunteered to report Norovirus to the CDC so the center could help the cruise lines control outbreaks if they happen.

The CDC only gets involved with Noro on cruise ships because ships are a closed environment. The CDC would love to be able to control Noro in other settings where it is common; senior living centers, grade schools, etc. But those places have people coming and going so there is just no way to stop the disease, and so they don't even ask those places to report it.

Because cruise ships report Noro, outbreaks get into the news and hence it has been named the "cruise ship disease." But in fact cruise ships only get Noro when someone brings it onboard, usually from a place where the virus is already rampant on land.

In 2010 the city of London had half a million cases of Noro and they had to close down most city hospital emergency rooms. But they don't call it the "London disease." In fact, many news reports about that incident still called it the "cruise ship disease."

How to Avoid Norovirus

The average Noro outbreak on a cruise ship affects less than 5% of the passengers, but it is a pretty violent virus, with vomiting and diarrhea as the most common symptoms, lasting for about 48 hours, so you want to avoid it. Here is a cruise ship secret:

You can tell when there has been an outbreak of at least 2% of the passengers when you start seeing the following procedures in place:

Passengers are no longer allowed to share food service utensils; everything will be served to you by a crewmember. You will also see people scrubbing common areas such as banisters in stairways and elevators. When you see these things, put yourself into "Noro-protection mode."

The virus can live on surfaces for several days. It is introduced into your system when you pick up virus particles and rub your eyes, nose or mouth. It is a very powerful virus; the common cold requires ingesting as many as 10,000 particles, but Noro only needs 10 to 100 particles to spread.

Neither soap nor alcohol will kill Noro - but you should still wash your hands wih soap very frequently! This can dislodge the virus from your hands - getting rid of it before you introduce it onto your system. The trick is to wash and rinse thoroughly (15 seconds) and then dry your hands with an absorbent, disposable paper towel. Be very careful what you touch, and if you must touch surfaces then do not touch your face until you have a chance to wash your hands.

One more thing - during the cruise embarkation process you are given a form asking if you have experienced any symptoms of illness in the preceding 48 hours. Important: if you admit to having any symptoms you can be denied your cruise immediately. They may tell you that they will have a nurse come and look at you before your cruise is denied, but that is not guaranteed in writing.

If you admit to being sick do not expect to be given a physical before you are denied your cruise. Yes, it sounds harsh, but I have had people contact me who checked the form because they had symptoms previously, but they actually felt fine at the time. However, Norovirus can live in a host for up to 2 days after symptoms pass and the cruise lines can use that fact to deny you your cruise. You have now been advised about these forms - how you respond is up to you.

Sea Sickness

Many first time cruisers are more afraid of sea sickness than anything, and it can be a horrible experience, but it is fully preventable, and prevention is the key word. There are many ways to control and prevent seasickness which we will discuss, but let's get to the main matters first.

First of all - sea sickness can be in the mind. The people who do not get sea sick have usually not really noticed they are on a moving ship. Meanwhile, I have also seen first-timers on ships think they are seasick when they probably really are not because the ship is not moving that much.

Timing is Important

The only reason people get sea sick is because they wait too long to react to the first signs. If you get a good preventative medicine in your system before Mal De Mer begins it will not take hold, but once it starts it is too late to introduce the medicine. Let me explain why.

The medicine I recommend first is meclizine. That is the generic name, and it is sold as Bonine or Dramamine 24-hour formula (this is different from the original Dramamine, also still available today) or as various store brand names.

The key is to take the meclizine before you get sick, otherwise your body may not be able to absorb it. Do not swallow the pill; the directions say to let it melt under your tongue. If you swallow it after you are already nauseated you won't absorb the medicine. Let it melt under your tongue at the first signs of sea sickness; these can be a vague tired feeling, a headache and/or light-headedness.

Other things will help keep seasickness at bay, but only under mild conditions. If you are caught in a real storm at sea and you start to feel unwell take the medicine. I realize some people just do not like pills, but you have to know that there is no natural preventative for seasickness as effective as meclizine. If one did exist it would already be well-known after literally thousands of years of sailing history.

Some other partial preventatives include real ginger root, wristbands with pressure points, sour apple and various homeopathic (tobaccum) formulae. But these only work up to a point, and if they stop working you had better hope it is not too late to take your meclizine. Also, you can take meclizine under the tongue and it will absorb, but once sea sickness has started the effect of the medicine will lessened. Always think "prevention" and not "cure" where sea sickness is concerned.

There are other effective medicines. The Scopolamine patch is popular. It was taken off the market in the early 2000s but apparently reformulated and reintroduced. If you are very sick and suffering there is an injectible form of medicine (meclizine or possibly compazine) a doctor can give you in the ship's infirmary, but you will have to pay a fee to get it.

The size of the ship is always a big factor when it comes to the possiblity of getting sea sick. Small "boats" move much more than big cruise ships. Anything below 30,000-tons may be too small for susceptible people, while ships as big as 150,000-tons will hardly sway perceptibly.

Cabin location is also extremely important. Think of a ship as a teeter-totter; the most stable area is halfway between the bow (front) and the stern (back), and on the lowest deck possible. The front moves more than the stern due to the forward motion of the ship going into waves.

Ships moving up and down is known as "pitching" while the side to side motion is "rolling." Rolluing can be controlled with stabilizers, fins guit in to the side of the ships hull, but stabilizers don't help pitching, which is actually more common and more sickening. The reason pitching is more common is that ships captains will sail into a wave rather than allow it to hit broadside.

Important: I am not a doctor. You can buy meclizine over the counter at a drug store, but anything you ingest can interfere with other medications or your personal health conditions. So, you must consult your personal physician before taking any medicine, even organic.